以SERVQUAL模式探討內科加護病房服務品質 —以某醫學中心為例

The Application of SERVQUAL Model to the Service Quality of Medical Intensive Care Units in a Medical Center

林秦蔚(Chin-wei Lin)

指導教授 ： 葉德豐

中臺科技大學/管理學院/健康產業管理研究所/碩士(2011年)

https://doi.org/10.6822/CTUST.2011.00065

摘要

中文摘要
背景：近年來，隨著社會變遷，國民所得與教育程度的提高、醫療技術快速的發展，民眾對醫療品質要求的提升，再加上病人與家屬消費者意識抬頭，醫療糾紛層出不窮，對於服務品質的需求也相對的提升，提供更好的醫療環境、醫療設備及良好的醫療品質而讓真正有醫療需求的急、重症病人能得到應有的照顧。
目標：透過SERVQUAL量表瞭解中部某醫學中心之內科加護病房家屬對醫院服務品質的期望與實際感受之相關及差異，探討影響內科加護病房住院服務品質之主要因素。
方法：針對中部某醫學中心內科加護病房病人家屬215位進行問卷訪查，以調整後的SERVQUAL量表調查病人家屬對於醫療服務的五大面向：有形性、可靠性、反應性、確實性、關懷性各自的期望程度與滿意程度。並計算期望與實際感受的落差。
結果：在本研究中顯示在病人家屬對醫療服務五大構面的期望與實際感受滿意度的差距量均為負值即表示病人家屬的實際感受滿意程度是低於其期望程度，而五大構面中以「關懷性」構面（平均-0.17）的差量為最小， 病人住院背景對務品質之期望程度均無顯著的差異，在病人家屬基本屬性除了年齡、教育程度外其他各種家屬屬性對服務品質之期望程度之相關變項無顯著影響。另在醫療服務品質的期望與實際感受滿意程度的差距量最大前五在有形性構面上佔有前四項，對於「加護病房家屬休息室設施及管理、現代化醫療設備、環境清潔、會客時間」的差距最大，在確實性構面「醫師具有良好的醫術是可以信賴的 」的差距居第五。因為這是病人與家屬最容易看到、最容易判斷的、是差距最大原因。
結論：.內科加護病房的病人來自急診為(56.3%)是屬於急病嚴重且需急需治療的病人，與一般病房的病人疾病程度不相同，醫療機構能提供優質的醫療環境、服務、增添醫療科技設備將有助於提升醫院的醫療服務品質，進而促使就診的民眾產生信心，對醫院的經營帶來正面的影響。本研究結果期望能提供醫療院所或其他主管機關在未來改善與推動加護醫療服務品質之參考。

關鍵字

SERVQUAL ； 醫療服務品質 ； 內科加護

並列摘要

Abstract
Background: Recently, following the transformation of the society, rise in national income and educational level, rapid development in medical technology, upgrading of requirements from the general public, and elevated consciousness of consumers among patients and their families, medical disputes and demand for quality service are increasing. Hospital authorities began to put emphasis on quality of service and degree of satisfaction of patients. Better medical environment and facilities, and desirable quality of medical service are needed for the acutely and seriously ill.
Objective: This study used SERVQUAL scale to investigate the relationship and difference between the expectation and actual satisfaction of family members of patients to the quality of service and the main factors affecting the quality of service in the medical intensive care unit of a medical center in central Taiwan.
Method: Questionnaires were given to 215 family members of patients in the medical intensive care unit of a medical center in central Taiwan. SERVQUAL scale was adjusted to investigate the expectation and satisfaction in the five aspects of medical service: tangibility, reliability, responsiveness, assurance, and empathy. The gap in expectation and actual feeling was evaluated.
Results: This study revealed that the gap between expectation and satisfaction in the five aspects of medical service among family members of patients was negative, implying that the actual satisfaction was lower than the expectation. The gap was the smallest in the aspect of empathy (mean -0.17). No significant gap was noted in the background of hospitalized patients and the expectation to quality of service. The basic attributes of family members other than age and education level showed no significant influence to the related variables of expectation of service quality. In the largest five gaps between expectation and actual satisfaction in the quality of medical service, the largest four were in the aspect of tangibility. The gap was the largest in “the facility and management of rest room in medical intensive care unit, modernized medical facility, clean environment, duration of visit”. The “good medical skill in physician and trustworthy” in the aspect of assurance was the fifth in the degrees of discrepancies. This was the most easily seen and judged by patients and their family members, and hence the largest gap.
Conclusion: Patients in medical intensive care unit were different from those in ordinary ward in that they were transferred from emergency room (56.3%) and were severely ill and required urgent treatment. The provision of good medical environment, service, and facility is beneficial to quality of service in hospitals, promotes confidence among patients, and is a positive influence to the operation of hospitals. The results of this study hopefully provide a reference for medical institutions and the health authority for the improvement and advancement of the quality of service of medical intensive care in the future.

並列關鍵字

quality of medical service ； medical intensive care ； SERVQUAL

參考文獻

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